A giant pyogenic granuloma

Abstract

Pyogenic granuloma is a rapidly growing, benign, vascular lesion that usually appears at the site of a penetrating injury, mostly on the fingers, facial skin, lips, and oral mucous membranes.1 It was first described by Poncet and Dor in 1897 as botryomycose “humaine.” Because of the granulomatous inflammation, the term pyogenic granuloma is used by most of authors to describe the lesion.1 Although the exact pathogenesis of pyogenic granuloma is unknown, it is closely related to minor trauma, chronic irritation, and hormonal influences.2 The condition does not develop unless the dermis has been injured by an external insult.1

Clinically, the lesion usually presents an ulcerated papule ranging in size from a few millimeters to several centimeters,3 and the lesion itself can be nearly 1 cm in diameter. Although all age groups may be affected, the lesions are seen mostly in patients between the ages of 11 and 40 years old.3 They often present with repeated bleeding that is refractory to pressure. A pyogenic granuloma rarely heals without medical ministrations and is usually necrotic. Histologically, proliferating vascular cells and a variable number of inflammatory cells are seen in an edematous stroma.4

There are various conservative treatment methods, such as laser surgery, chemical cauterization, sclerotherapy, and cryotherapy, but the recurrence rate is high. Pyogenic granuloma can be cured completely by full-thickness excision of the skin with the base of the lesion